Î For women with recent transient ischemic attack (TIA) or ischemic
stroke (IS) and ipsilateral moderate (50%-69%) carotid stenosis, carotid
endarterectomy (CEA) is recommended depending on patient-specific
factors, such as age and comorbidities, if the perioperative morbidity and
mortality risk is estimated to be <6% (I-B).
Î When CEA is indicated for women with TIA or stroke, surgery within
2 weeks is reasonable rather than delaying surgery, if there are no
contraindications to early revascularization (IIa-B).
Î Aspirin therapy (75-325 mg/d) is reasonable in women with diabetes
mellitus unless contraindicated (IIa-B).
Î If a high-risk (ie, 10-year predicted CVD risk ≥10%) woman has an
indication for aspirin but is intolerant of aspirin therapy, clopidogrel
should be substituted (I-B).
Î Aspirin therapy can be useful in women ≥65 years of age (81 mg/d or
100 mg every other day) if BP is controlled and the benefit for IS and MI
prevention is likely to outweigh the risk of gastrointestinal bleeding and
hemorrhagic stroke (IIa-B) and may be reasonable for women <65 years
of age for IS prevention (IIb-B).
Treatment
